Abstract: Introduction: Lung cancer is the leading cause of UK cancer deaths, largely due to late presentation. Several recent pilot studies aiming to speed-up the suspected lung cancer diagnostic pathway have been described. At Princess Alexandra Hospital, a new ‘Abnormal GP Chest X-ray (CXR) Straight to CT Pathway’, triggered directly by Radiology following reporting of suspicion of malignancy, commenced in October 2017, with direct MDT-referral of resultant CTs consistent with lung cancer. Here, we assessed the new Pathway’s: (1) case numbers, (2) incidence of new cancer diagnoses, and (3) diagnostic speed.

Materials & Methods: All cases referred to the Pathway from October 2017 to January 31st 2018 were reviewed and compared with reported abnormal GP CXR cases in the same period the year before.

Results: There was no significant difference in the case numbers or general patient demographics in the two time periods; however, as expected, the time from CXR request to CT Report was significantly quicker with the new Pathway (10.6 +/- 1.2 versus 17.1 +/- 1.7 days, p<0.01), mainly due to a significant reduction in the time from CXR Report generation to follow-up CT (2.4 +/- 0.5 versus 9.5 +/- 0.9 days, p<0.01). On average, there were 15 monthly Pathway cases (from ~2000 monthly GP CXRs performed), with follow-up CT consistent with malignancy in 51% (23/45 cases).

Conclusion: Assessment of the Pathway’s first 3 months demonstrated a significant improvement (of approximately 1 week) in the speed from CXR to CT, and hence potential new cancer diagnosis. Summary: Assessment of the new Abnormal GP Chest X-ray (CXR) Straight to CT Pathway’s first 3 months demonstrated a significant improvement (of approximately 1 week) in the speed from CXR to CT, and hence potential new cancer diagnosis. Report abuse »